Introduction: During the current pandemic, there has been a paucity of Greek data in terms of recording the general long-term functional status of patients after coronavirus disease 2019 (COVID-19) hospitalizations, as well as very little information regarding rehabilitation services nationwide and their utilization.Objective-design: This is a prospective cohort study, including 92 adults discharged from the Infectious Disease Unit of a third-level hospital in Greece after hospitalization with COVID-19. Demographics and disease severity data was collected upon admission and symptoms at discharge, 4 months and 1 year. Following rating of 12 common symptoms on a Likert scale, quality-of-life data and accessibility to rehabilitation services were compared among the 3 time points. Results: At discharge, the most prevalent complaints were fatigue, exertional dyspnoea and difficulty walking. At 4 months, these 3 remained among the most prevalent symptoms, while pain and memory/loss concentration remained at high numbers as well. Finally, at the 1-year mark, the percentages of patients reporting fatigue, exertional dyspnoea and pain were the highest. At the 4-month follow-up, only 4.3% of the study participants had visited a rehabilitation facility of any kind, whereas at the 1-year mark the percentage rose to 10.9%. Conclusion: A clinically relevant number of participants experienced at least one post-COVID-19 hospitalization symptom. Quality of life was markedly affected by the longer-term effects of the disease. The percentage of people finally attending any kind of rehabilitation service was poor. With thousands more being infected and needing hospitalization nationwide daily, the need for the inclusion of relevant rehabilitation programmes in the Greek healthcare system appears imminent. LAY ABSTRACTFor this research paper, we studied 92 adults discharged from the Infectious Disease Unit of a third-level hospital after hospitalization with COVID-19, examining their quality of life and accessibility to rehabilitation services among 3 time points: discharge, 4 months and 1 year afterwards. At discharge, the most prevalent complaints were fatigue, exertional dyspnoea and difficulty walking. At 4 months, these 3 remained among the most prevalent symptoms, while pain and memory/loss concentration remained at high numbers as well. Finally, at the 1-year mark, the percentages of patients reporting fatigue, exertional dyspnoea and pain were the highest. Quality of life was markedly affected by the longer-term effects of the disease. The percentage of people finally attending any kind of rehabilitation service was poor. Without a doubt, the need for inclusion of rehabilitation programmes in the healthcare systems is imminent in order to face the continued pandemic challenge.
The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), first identified in the region of Wuhan, China is responsible for the ongoing pandemic of coronavirus disease-19 (COVID-19) that has been a part of our life for almost three years now. Although there have been multiple reports of prolonged viral shedding in people with severe disease, viral shedding lasting for extended periods can occur in patients with less serious clinical insults or even asymptomatic individuals. Herein, we report a case of a female patient that, although otherwise asymptomatic, remained positive on nasopharyngeal viral testing for a prolonged period, alongside persisting complaints of anosmia and ageusia. The patient may well have been one of the first individuals to be infected in the Greek territory; we followed up on her long-term COVID sequelae from the time of proof of infection up until the present day.
Background-Purpose: The ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has affected our everyday lives for the last three years, leading to in numerous patient hospitalizations all over the world and a plethora of therapeutic interventions being implemented in an effort to combat the disease. Baricitinib is an oral selective Janus kinase (JAK) inhibitor approved for the treatment of rheumatic disease that was hypothesized to bear positive effect on the more severe forms of the novel coronavirus disease 2019 (COVID-19) based on its antiviral and anti-cytokine properties. The purpose of the current prospective cohort study was to study the effect of adding baricitinib to the usual drug regimen of patients hospitalized with severe COVID-19 in the infectious disease unit of a third-level hospital. Patients-Methods: The current prospective cohort study was conducted at the Infectious Disease Unit of the 401 General Military Hospital of Athens, recruiting a total of 74 patients who were hospitalized with severe COVID-19 based on the COVID-19 severity index. Relevant demographic data, personal and family medical history and turnout of the cases was documented. Laboratory examinations as well as arterial blood gases (ABGs) were recorded and analysed both upon admission and discharge of the patients. An oral dose of 4 mg baricitinib daily (or an adjusted dose of 2 mg daily in cases of renal disease) was added to the usual therapeutic regimen of the patients. Results: For the purpose of the current study, we recruited 74 patients (male sex 81.1%, mean age 52,8±17,2 years old). Six patients (8.1%) were fully vaccinated and 32 patients (43.2%) presented at least one comorbidity (chronic cardiovascular disease, chronic liver disease, chronic kidney disease, immunosuppression, diabetes mellitus or obesity). Mean hospitalization time reached 10.9 ± 5.8 days while mean time of baricitinib administration was 9.2 ± 2.9 days. Regarding outcomes of hospitalizations, 12 patients (16.2%) needed to be transferred to the intensive care unit (ICU), with 6 of them finally succumbing to the disease. Administration of the drug led to a statistically significant drop of inflammatory markers as well as a statistically significant improvement of respiratory function as evaluated by ABGs. No serious adverse events were recorded. Conclusion: The addition of oral baricitinib to the standard drug regimen of hospitalized patients with severe COVID-19 proved safe and efficacious in managing symptoms of the disease, leading to swift clinical complaint and laboratory profile improvements.
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